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Study results may help improve treatments for premenstrual disorder

Researchers at the University of North Carolina at Chapel Hill School of Medicine recently presented the preliminary results from a study that may lead to improved treatments for women with premenstrual dysphoric disorder (PMDD) who also have a history of depression.

NEWS
 
Sept. 10, 2003
 

Study results may help improve treatments for premenstrual disorder

 

CHAPEL HILL -- Researchers at the University of North Carolina at Chapel Hill School of Medicine recently presented the preliminary results from a study that may lead to improved treatments for women with premenstrual dysphoric disorder (PMDD) who also have a history of depression.

The research is being led by Dr. Susan S. Girdler, associate professor of psychiatry in UNC’s School of Medicine. Other UNC researchers include Drs. Leslie Morrow and Kathleen Light, both professors of psychiatry. Their findings were presented earlier this week at the 34th annual meeting of the International Society for Psychoneuroendocrinology in New York.

Women with PMDD who have histories of depression have worse premenstrual dysphoric symptoms than other women who have PMDD, research indicates. In addition, women with PMDD have more life stress, including traumatic stress histories (for example, sexual and physical abuse), and report greater negative emotional impact of stress as compared to non-PMDD women.

 The new UNC study examines the role of the neurosteroid hormone allopregnanolone, or ALLO, which plays a role in moderating anxiety and mood.

“The focus of the ongoing UNC study is two-fold,” Girdler said. “One, to examine the influence of histories of depression on ALLO concentrations and reactivity to stress in PMDD and non-PMDD women and, two, to investigate alterations in the metabolism of progesterone to ALLO as a function of PMDD status and histories of depression.”

The study involved women with PMDD and non-PMDD women, recruited with and without past histories of depression. All women were tested at the same premenstrual phase of their cycle, with the tests examining ALLO concentrations at rest and after a 25-minute mental stress battery (speech and mental arithmetic).

Preliminary results indicated that only women with PMDD who also have a history of depression showed significantly higher elevated ALLO concentration levels at rest, but a blunted ALLO response to stress. These findings are consistent with the idea that PMDD is a heterogeneous disorder with different

 “pathophysical” mechanisms for different subgroups of PMDD women. The findings also indicate that PMDD women with prior depression may be most vulnerable to stress.

Histories of depression also appear to alter the way that women metabolize progesterone, causing an increase in the conversion of progesterone to ALLO.

“The results of this study are exciting for the potential treatment of premenstrual dysphoric disorder,” said Girdler. “The possible implications of these findings show us that histories of depression may have special relevance in PMDD. Additionally, understanding the link between ALLO and PMDD could allow for the development of pharmacologic agents that could target ALLO (in its conversion from progesterone) to prevent mood irregularities.”

For information about enrolling in this study or others at UNC involving PMDD, call Katie at (919) 966-2547. Eligible participants will receive diagnostic feedback on the menstrual symptoms, in addition to up to $500 for study completion.

Funding for the study was provided by the National Institute of Mental Health.

Note: To schedule an interview with Girdler, call (919) 966-9115.

 

UNC department of psychiatry contact: Crystal Hinson Miller, (919) 966-9115 or hinsonmiller@med.unc.edu

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